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Background <p>Sheehan’s syndrome is a form of maternal hypopituitarism resulting from excessive blood loss during or after childbirth. This extensive bleeding may reduce blood flow to the pituitary gland, causing pituitary cell damage and death (necrosis). The incidence of Sheehan’s syndrome has decreased in developed countries, whereas in developing countries, it remains a substantial cause of morbidity and mortality among at-risk populations.</p> Case presentation <p>We describe the case of a 59-year-old patient of mestizo ethnicity, with an unusual presentation of Sheehan’s syndrome 38 years after postpartum hemorrhage that affected hormone secretion at the adenohypophysis. During hospitalization, central adrenal insufficiency, low free thyroxine levels, decreased pituitary gland size, hypogonadotropic hypogonadism, and growth hormone deficiency were noted. The patient was treated with hydrocortisone and levothyroxine, with satisfactory clinical progress and improvement in her quality of life.</p> Conclusion <p>Late-onset Sheehan’s syndrome is a progressive disease, with nonspecific symptoms, which leads to delayed diagnosis and, if not treated in time, may have fatal consequences.</p>

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Late-onset Sheehan’s syndrome: a major diagnostic challenge—a case report

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年2月26日

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  • Luis Miguel Osorio-Toro,
  • Yessica Alejandra Ordoñez-Guzman,
  • Jhon Fernando Montenegro-Palacios,
  • Jhon Herney Quintana-Ospina,
  • Julian Andres Pacichana-Abadia,
  • Jorge Enrique Daza-Arana,
  • Hector Fabio Escobar-Vargas,
  • Katherine Restrepo-Erazo,
  • Andrés Felipe García-Ramos

摘要

Background

Sheehan’s syndrome is a form of maternal hypopituitarism resulting from excessive blood loss during or after childbirth. This extensive bleeding may reduce blood flow to the pituitary gland, causing pituitary cell damage and death (necrosis). The incidence of Sheehan’s syndrome has decreased in developed countries, whereas in developing countries, it remains a substantial cause of morbidity and mortality among at-risk populations.

Case presentation

We describe the case of a 59-year-old patient of mestizo ethnicity, with an unusual presentation of Sheehan’s syndrome 38 years after postpartum hemorrhage that affected hormone secretion at the adenohypophysis. During hospitalization, central adrenal insufficiency, low free thyroxine levels, decreased pituitary gland size, hypogonadotropic hypogonadism, and growth hormone deficiency were noted. The patient was treated with hydrocortisone and levothyroxine, with satisfactory clinical progress and improvement in her quality of life.

Conclusion

Late-onset Sheehan’s syndrome is a progressive disease, with nonspecific symptoms, which leads to delayed diagnosis and, if not treated in time, may have fatal consequences.